Obesity and metabolic syndrome (MetS) are associated with colorectal neoplasia (CRN) and carcinoma (CRC). Whether such subjects must undergo screening colonoscopy (SC) earlier, is unknown. Incidences of CRNs in 40–49- versus 50–65-year-old bariatric patients were compared by SC. No prospective data on SC is available in morbidly obese/MetS.
Material and Methods
Surgical weight loss candidates over 39 years of age, asymptomatic, and average-risk for CRC offered SC. Those giving written informed consent were enrolled. Colonoscopies were done by the same surgeon. Smoking/drinking history, fasting blood glucose (FBG), insulin, C-peptide, triglyceride, high density lipoprotein, vitamin D, HbA1c, and insulin resistance parameters were recorded. CRN rate and the distribution of variables in patients 40–49 years of age were compared with 50–65. Student’s t and Chi-square tests were used as appropriate. P < 0.05 was regarded as statistically significant.
Among 168 SCs, 47 had CRNs (27.9%). Including carcinoma, 15 had an advanced CRN (aCRN) (8.9% aCRN and 0.6% CRC). CRN rate was 35.6% in ≥ 50 years old whereas 22.1% in 40–49 (p = 0.053). aCRN rates (8.4% in 40–49 versus 9.6% in 50–65) were similar (p = 0.792). Metabolic parameters and smoking-drinking history were equally distributed between the groups except FBG and HbA1c as their mean levels were slightly higher in the 50–65 age group (p < 0.05).
Presented results warrant routine SC in the 40–49-year-old morbidly obese and/or MetS patient population with average risk, and in aged > 50, it certainly must be enforced and included in the preoperative check-list if not done before.
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Toydemir, T., Özgen, G., Çalıkoğlu, İ. et al. A Comparative Study Evaluating the Incidence of Colorectal Neoplasia(s) in Candidates for Bariatric Surgery by Screening Colonoscopy, 40–49 Versus 50–65 Years Old: a Preliminary Study. OBES SURG 29, 2430–2435 (2019). https://doi.org/10.1007/s11695-019-03819-2
- Screening colonoscopy
- Metabolic syndrome
- Morbid obesity